Objectives: To determine the level of concern among migraineurs about migraine prescription medication tolerability and adverse effects and the impact of these concerns on their self-management of migraine.

Methods: Self-completion questionnaires were mailed from the National Family Opinion household panel to a prequalified sample of 4000 adults (aged 18 years or older) who reported severe headache and migraine. Those who met the International Headache Society symptom criteria for migraine and reported use of prescription medication to treat their migraines were included in the descriptive analysis.

Results: A total of 2444 (61%) sufferers of severe headache/migraine returned a completed survey, and 56% of these (n=1160) met the target criteria for the study. Of those meeting the criteria, pain relief and speed of onset were important product attributes for 75% to 77% of sufferers, and the absence of adverse effects was important to over 40%. Two-thirds of sufferers specifically had delayed or avoided taking a current prescription medication because of concerns about adverse effects. These concerns led to a delay in taking medication in 37% of treated migraine episodes and to medication avoidance in 44% of untreated attacks during the previous 6 months, resulting in more intensive and longer duration of pain, the need to rest and cancel social activities, and suboptimal performance. Almost 8 of 10 (79%) sufferers showed an interest in trying a novel product with similar efficacy but fewer adverse effects than other prescription migraine medications.

Conclusions: Adverse effects are an important factor in migraine management, and concern about adverse effects significantly affected patient compliance.